Allogeneic haemopoietic transplantation for acute myeloid leukaemia in second complete remission: a registry report by the Acute Leukaemia Working Party of the EBMT

Maria H. Gilleece, Myriam Labopin, Bipin N. Savani, Ibrahim Yakoub-Agha, Gerard Socié, Tobias Gedde-Dahl, Didier Blaise, Jennifer L. Byrne, Charles Craddock, Jan J. Cornelissen, William Arcese, Edouard Forcade, Charles Crawley, Emmanuelle Polge, Mohamad Mohty, Arnon Nagler

Research output: Contribution to journalArticle

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Abstract

Allogeneic haemopoietic cell transplant (allo-HCT) may be curative in acute myeloid leukaemia (AML) in second complete remission (CR2) but the impact of reduced intensity (RIC) versus myeloablative conditioning (MAC) is uncertain. The Acute Leukaemia Working Party of the European Society for Blood and Bone Marrow Transplantation Registry studied an AML CR2 cohort characterised by age ≥ 18 years, first allo-HCT 2007–2016, available cytogenetic profile at diagnosis, donors who were matched family, volunteer unrelated with HLA antigen match 10/10 or 9/10 or haplo-identical. The 1879 eligible patients included 1010 (54%) MAC allo-HCT recipients. In patients <50 years (y), two year outcomes for MAC vs RIC allo-HCT were equivalent with leukaemia-free survival (LFS) 54% for each, overall survival (OS), 61% vs 62%, non-relapse mortality (NRM) 18% vs 15% and graft versus host disease relapse-free survival (GRFS) 38% vs 42%. In patients ≥50 y, 2 y outcomes for MAC vs RIC allo-HCT were equivalent for LFS 52% vs 49%, OS 58% vs 55% and GRFS 42.4% vs 36%. However, NRM was significantly inferior after MAC allo-HCT, 27% vs 19% (P = 0.01) despite worse cGVHD after RIC-allo (32% vs 39%). These data support the need for ongoing prospective study of conditioning intensity and GVHD mitigation in AML.

Original languageEnglish (US)
Pages (from-to)87-99
Number of pages13
JournalLeukemia
Volume34
Issue number1
DOIs
StatePublished - Jan 1 2020

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Homologous Transplantation
Acute Myeloid Leukemia
Registries
Leukemia
Transplants
Survival
Mortality
Graft vs Host Disease
HLA Antigens
Bone Marrow Transplantation
Cytogenetics
Disease-Free Survival
Conditioning (Psychology)
Volunteers
Tissue Donors
Prospective Studies
Recurrence

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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Allogeneic haemopoietic transplantation for acute myeloid leukaemia in second complete remission : a registry report by the Acute Leukaemia Working Party of the EBMT. / Gilleece, Maria H.; Labopin, Myriam; Savani, Bipin N.; Yakoub-Agha, Ibrahim; Socié, Gerard; Gedde-Dahl, Tobias; Blaise, Didier; Byrne, Jennifer L.; Craddock, Charles; Cornelissen, Jan J.; Arcese, William; Forcade, Edouard; Crawley, Charles; Polge, Emmanuelle; Mohty, Mohamad; Nagler, Arnon.

In: Leukemia, Vol. 34, No. 1, 01.01.2020, p. 87-99.

Research output: Contribution to journalArticle

Gilleece, MH, Labopin, M, Savani, BN, Yakoub-Agha, I, Socié, G, Gedde-Dahl, T, Blaise, D, Byrne, JL, Craddock, C, Cornelissen, JJ, Arcese, W, Forcade, E, Crawley, C, Polge, E, Mohty, M & Nagler, A 2020, 'Allogeneic haemopoietic transplantation for acute myeloid leukaemia in second complete remission: a registry report by the Acute Leukaemia Working Party of the EBMT', Leukemia, vol. 34, no. 1, pp. 87-99. https://doi.org/10.1038/s41375-019-0527-4
Gilleece, Maria H. ; Labopin, Myriam ; Savani, Bipin N. ; Yakoub-Agha, Ibrahim ; Socié, Gerard ; Gedde-Dahl, Tobias ; Blaise, Didier ; Byrne, Jennifer L. ; Craddock, Charles ; Cornelissen, Jan J. ; Arcese, William ; Forcade, Edouard ; Crawley, Charles ; Polge, Emmanuelle ; Mohty, Mohamad ; Nagler, Arnon. / Allogeneic haemopoietic transplantation for acute myeloid leukaemia in second complete remission : a registry report by the Acute Leukaemia Working Party of the EBMT. In: Leukemia. 2020 ; Vol. 34, No. 1. pp. 87-99.
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abstract = "Allogeneic haemopoietic cell transplant (allo-HCT) may be curative in acute myeloid leukaemia (AML) in second complete remission (CR2) but the impact of reduced intensity (RIC) versus myeloablative conditioning (MAC) is uncertain. The Acute Leukaemia Working Party of the European Society for Blood and Bone Marrow Transplantation Registry studied an AML CR2 cohort characterised by age ≥ 18 years, first allo-HCT 2007–2016, available cytogenetic profile at diagnosis, donors who were matched family, volunteer unrelated with HLA antigen match 10/10 or 9/10 or haplo-identical. The 1879 eligible patients included 1010 (54{\%}) MAC allo-HCT recipients. In patients <50 years (y), two year outcomes for MAC vs RIC allo-HCT were equivalent with leukaemia-free survival (LFS) 54{\%} for each, overall survival (OS), 61{\%} vs 62{\%}, non-relapse mortality (NRM) 18{\%} vs 15{\%} and graft versus host disease relapse-free survival (GRFS) 38{\%} vs 42{\%}. In patients ≥50 y, 2 y outcomes for MAC vs RIC allo-HCT were equivalent for LFS 52{\%} vs 49{\%}, OS 58{\%} vs 55{\%} and GRFS 42.4{\%} vs 36{\%}. However, NRM was significantly inferior after MAC allo-HCT, 27{\%} vs 19{\%} (P = 0.01) despite worse cGVHD after RIC-allo (32{\%} vs 39{\%}). These data support the need for ongoing prospective study of conditioning intensity and GVHD mitigation in AML.",
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AU - Cornelissen, Jan J.

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